Patient discharge system and method for self-care of a post-surgery drain

ABSTRACT

A patient discharge system and method for self-care of a post-surgical drain site by a patient are revealed. The system contains apparatus for at least one dressing change and includes non-latex gloves, measuring cups, gauze pads, adhesive tape remover pads, a pencil, antibacterial soap, tape, belt bags, numbered drain labels, split gauze pads with foam support bars, drainage record cards, a set of step-by-step instructions and a box having a ruler on an inside of the box top. The system includes one set of step-by-step instructions for a medical professional to instruct a patient in the use of the patient discharge system. A copy of the step-by-step instructions is included for acknowledgment by the user and retained by the medical professional for medical records.

CROSS-REFERENCE TO RELATED APPLICATION

This application claims the benefit of U.S. Provisional Application No.60/181,668, filed Feb. 11, 2000.

COPYRIGHT NOTICE

A portion of the disclosure of this patent document contains materialwhich is subject to copyright protection. The copyright owner has noobjection to the facsimile reproduction by anyone of the patent documentor the patent disclosure, as it appears in the Patent and TrademarkOffice patent file or records, but otherwise reserves all copyrightrights whatsoever.

DESCRIPTION

The present invention generally relates to a patient discharge systemand method for self-care of a post surgery drain, and in particular to amethod and apparatus for the post-surgical drain care of an operativesite by a patient or health care provider.

BACKGROUND OF THE INVENTION

Surgery may be necessary for many reasons. Surgery may offer a patientthe only chance of survival in an emergency or slow down the rate of aprogressive disease, such as cancer. Surgery may also be performed toimprove the quality of a patient's life, as in a total hip replacement.It may be done to improve a patient cosmetically. Surgery may also beperformed as a diagnostic aid, for instance, the removal of a mole orenlarged gland to test for malignancy. It may be performed to removesome obstruction or disturbance of normal bodily function, such as agall bladder containing stones. Many other types of surgeries arepreformed on a regular basis.

When a surgical operation is complete, the surgeon closes the incision.In general, the surgeon stitches the underlying tissues with suturesthat are eventually absorbed by the body tissues and uses a similar typeof material to sew the layer of connective tissue beneath the skin.Finally, the surgeon joins the edges of the skin together. This is donewith either non-absorbable thread stitches or staples.

If the incision is in an area under a great deal of pressure, forexample, a large abdominal incision, the surgeon may insertlarge-tension stitches to support the skin stitches, particularly if thepatient has a chest problem and may strain the incision by coughing.Clips tend to mark the skin less than stitches, but generally cannot beused if the area of the incision is under great tension.

It is sometimes necessary to leave a drain in or near the incision toallow blood and other secretions to escape, either into the dressing orinto a suitable container. The drain is either a tube or a piece ofplastic or rubber. This is normal procedure following an operation suchas a cholecystectomy.

In modern post-operative care, every effort is made to have the patientout of bed and moving around as soon as possible. After most operations,it is possible to return home before the stitches are removed. A patientis usually advised of what activities are allowed and is provided withgeneral instructions to follow. However, there is no specific method orsystem which provide patients with detailed instructions and apparatusfor post-surgical drain care. Thus, there is a need for a method andsystem for the post-surgical drain care of an operative site by apatient or health care provider in the patient's home.

SUMMARY OF THE INVENTION

The present invention provides a patient discharge system or apparatusand method for self-care of a post-surgical drain site by a patient. Thesystem contains apparatus for at least one dressing change andcomprises: (I) at least one pair of non-latex gloves; (II) at least onemeasuring cup; (III) at least one gauze pad; (IV) at least one adhesivetape remover pad; (V) at least one pencil; (VI) antibacterial soap; (VI)at least one piece of tape; (VII) at least one belt bag; (IX) at leastone numbered drain label; (X) at least one split gauze pad with foamsupport bar; (XI) at least one drainage record card; (XII) at least oneset of step-by-step instructions; and (XIII) a container with a ruler,where the above-named items are positioned inside the container.

In preferred embodiments of the system, the system contains sufficientapparatus for 30 dressing changes, the antibacterial soap is in liquidform, the tape is in a roll and is Micropore™ tape, the measuring cup iscalibrated, and the step-by-step instructions, the numbered drain labeland the drainage record card are written in English, but other languagessuch as Spanish are contemplated. It is also contemplated that onepreferred embodiment of the system includes a contents map identifyingthe contents and their positions.

In a more preferred embodiment of the system, the system includesapparatus for at least 30 dressing changes as provided above andcomprises: (I) 20 pairs of non-latex gloves; (II) 30 calibratedmeasuring cups; (III) 30 gauze pads; (IV) 30 adhesive tape remover pads;(V) a pencil; (VI) antibacterial liquid soap; (VII) a roll of Micropore™tape; (VIII) 4 belt bags; (IX) 4 numbered drain labels; (X) 30 splitgauze pads with foam support bars; (XI) 4 drainage record cards; (XII) acontents map; (XIII) a set of step-by-step instructions; and (XIV) a boxhaving a box top with a ruler on an inside of the box top, whereinabove-named items are positioned inside the box. If a waste bag isincluded in the system, the preferred embodiment also includes (XV) 15plastic waste bags, otherwise waste bags may be provided by the user.

The method for self-care of a post-surgical drain site by a patientcomprises changing a dressing of a post-surgical drain site with theapparatus in the system of the present invention in accordance with thedetailed instructions in the system of the present invention. In apreferred embodiment, the method which is discussed in further detailbelow generally includes: (I) preparing for self-care; (II) draining theincision; (III) removing the old dressing; and (IV) replacing thedressing.

The present invention also includes a method for instructing oreducating a user in self-care of a post-surgery drain site using thepatient discharge system of the present invention. This patienteducation system includes a set of step-by-step instructions used by aninstructor to train a user in caring for a post-surgery drain site,preferably using the system and a copy of the instructions or self-caredocumentation of the system.

It is therefore an object of the present invention to provide a patientdischarge system and method for self-care of a post-surgery drain.

It is a further object to provide detailed instructions for post surgeryself-care using the contents of a self-care a patient discharge system.

An additional object is to provide detailed instructions to be used by amedical professional in instructing users in the use of the self-care apatient discharge system.

Other objects, features and advantages of the invention will be apparentfrom the following detailed disclosure, taken in conjunction with theaccompanying sheets of drawings, wherein like numerals refer to likeparts, components and processes.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a perspective view of one embodiment of the patient dischargesystem of the present invention;

FIG. 2 is a top plan view of one embodiment of the contents map inEnglish and Spanish for the patient discharge system of the presentinvention;

FIGS. 3A and 3B are top plan views of one embodiment of the step-by-stepinstructions in English for the patient discharge system of the presentinvention;

FIG. 4 is a top plan view of one embodiment of a copy of thestep-by-step instructions in English used by a medical professional fordocumenting that the users are instructed in the use of the patientdischarge system of the present invention;

FIG. 5 is a top plan view of one embodiment of the numbered drain labelsfor the patient discharge system of the present invention;

FIG. 6 is a top plan view of one embodiment of a drainage record cardfor the patient discharge system of the present invention;

FIGS. 7A, 7B, 7C and 7D are top plan views of an alternative embodimentof the step-by-step instructions in English for the patient dischargesystem of the present invention; and

FIGS. 8A and 8B are top plan views of an alternative embodiment of acopy of the step-by-step instructions in English used by a medicalprofessional for documenting that the users are instructed in the use ofthe patient discharge system of the present invention.

DETAILED DESCRIPTION OF THE INVENTION

Referring now to the drawings, and particularly FIGS. 1, 2, 5 and 6, thepresent invention provides a method and or system 10 for thepost-surgical drain care of an operative site by a user, whether apatient, care-giver, in-home-care provider or health-care provider. Themethod and system 10 provide everything that the user needs for in-homecare. For brevity, the patient, care-giver, in-home-care provider andthe health-care provider are referred to herein collectively as the“patient” or “user.”

In general, the post-surgery drain system 10 contains at least: (I)infection prevention devices (gloves, gauze pads and soap); (II)securing devices (tape and belts); (III) measuring and labeling devices(measuring cups, a pencil, labels, record cards and a ruler); and (IV)information devices (instructions) among other items. More specifically,the post-surgery drain care system of the present invention is comprisedof the following: (I) non-latex gloves 12; (II) measuring cups 14; (III)gauze pads 16; (IV) adhesive tape remover pads 18; (V) a pencil 22 orother suitable writing instrument; (VI) antibacterial soap 24; (VII)tape 26; (VIII) belt bags 28; (IX) numbered drain labels 30; (X) splitgauze pads with foam support bars 32; (XI) drainage record cards 34;(XII) step-by-step instructions 38; and (XIII) a container or box 40with a ruler 42. It is contemplated that system 10 also includes acontents map 36. The system may alternatively include waste bags 20.

More specifically, the container 40 of the system contains the non-latexgloves 12, the measuring cups 14, the gauze pads 16, the adhesive taperemover pads 18, the pencil 22, the antibacterial soap 24, the tape 26,the belt bags 28, the numbered drain labels 30, the split gauze padswith foam support bars 32, the drainage record cards 34, the contentsmap 36 and the step-by-step instructions 38 and 38A (see FIGS. 3A and 3Bor 7A, 7B, 7C and 7D, respectively) as shown in the contents map 36 (seeFIGS. 1 and 2). It should be appreciated that the system 10 could alsobe provided to the patient in a bag, tray or any other suitablecontainer. A box is preferred as it is strong enough to protect thecontents of the system 10 and is suitable for shipping and storing. If abag, tray or other container are used, a contents map 36 may or may notbe included with system 10.

In one preferred embodiment, a clinician or other medical professionalprovides the system to the patient or user, although it is contemplatedthe user could obtain the system through other means. The system 10includes a set of extremely detailed and specific step-by-stepinstructions 38 and 38A as illustrated in FIG. 3A and 3B and 7A, 7B, 7Cand 7D, respectively. The instructions 38 and 38A are preferably incolor for ease of use by the patient. This system also includes a blackand white copy of the instructions 44 and 44A, respectively, asillustrated in FIG. 4 and FIGS. 8A and 8B. The copies do not include theillustrations of the step-by-step instructions 38 and 38A. Thisdocumentation 44 and 44A includes acknowledgement sections 45 a, 45 b,45 c, 45 d, 45 e, 45 f, 45 g, and 45 h. It should be appreciated thatthe system 10 could also include an instructional video for trainingusers in the use of the system 10.

In one of the preferred embodiments, the system 10 contains sufficientapparatus for 30 dressing changes, the antibacterial soap 24 is inliquid form, the tape 26 is in a roll and is Micropore™ tape, themeasuring cup 14 is calibrated and the step-by-step instructions 38, thecontents map 36 (if included), the numbered drain label 30 and thedrainage record card 34 are written in English. It is also contemplatedthat refills for the system 10 can be provided.

In a more preferred embodiment of the system, the system 10 containsapparatus for at least 30 dressing changes and comprises: (I) 20 pairsof non-latex gloves 12; (II) 30 calibrated measuring cups 14; (III) 30gauze pads 16; (IV) 30 adhesive tape remover pads 18; (V) a pencil 22;(VI) antibacterial liquid soap 24; (VII) a roll of Micropore™ tape 26;(VIII) 4 belt bags 28; (IX) 4 numbered drain labels 30; (X) 30 splitgauze pads with foam support bars 32; (XI) 4 drainage record cards 34;(XII) a contents map 36; (XIII) a set of step-by-step instructions 38;and (XIV) a box 40 having a box top with a ruler 42 on an inside of thebox top, wherein above-named items are positioned inside the box.

Using the step-by-step instructions 38 or 38A, and the contents map 36,users can easily identify when each item is required in the method andreadily find it in the container 40. It should be appreciated that theitems and step-by-step instructions could be color coded and/or useicons making identifying each item even easier. For example, the gauzepads could be identified by a band aid icon and blue coloringcorresponding to a band aid icon and blue coloring in the step-by-stepinstructions.

The method for self-care of a post-surgical drain site by a patientcomprises changing a dressing of a post-surgical drain site using thesystem 10 in accordance with the detailed instructions 38 or 38A. In apreferred embodiment, the method generally includes: (I) preparing forself-care; (II) draining the incision; (111) removing the old dressing;and (IV) replacing the dressing.

Preparing For Self-care (Step I)

The first step of one embodiment of the method of the present invention,as illustrated in FIGS. 3A and 3B, includes preparing for self-care.Preparing for self-care includes: (I) obtaining a clean, fresh towel;(II) (a) washing using antibacterial soap 24 and warm water; and (b)using the clean towel for drying; (III) finding a flat, solid surface;(IV) setting out a measuring cup 14 for each drain; (V) preparing awaste bag 20 which includes: (a) obtaining a waste bag 20 either fromsystem 10 or some other source; and (b) opening the waste bag 20; (VI)setting the waste bag 20 on the flat surface so it is ready for wastematerials; (VII) preparing the tape which includes: (a) taking the tape26 out of the container 40; (b) measuring the tape 26 using the ruler42; (c) tearing the tape 26 into two strips approximately four incheslong for each drain; and (d) attaching a small corner of each piece oftape 26 to the edge of the counter, table or other surface; and (VII)labeling each drain using the numbered drain labels 30 (see FIG. 5)which includes: (a) peeling the labels 30 off the backing starting withthe Drain 1 label; and (b) wrapping one label around each tube near thebulb. It should be appreciated that this process can be skipped if thedrains are labeled.

An alternative embodiment of the first step of the method of the presentinvention, as illustrated in FIGS. 7A, 7B, 7C and 7D includes preparingfor self-care. Preparing for self-care includes: (I) finding a flatsolid surface to work on such as a table or counter; (II) finding agarbage bag and setting it up to put in used apparatus; (III) obtaininga clean, fresh towel; (IV) (a) washing using antibacterial soap 24 andwarm water; and (b) using the clean towel for drying; (V) setting out ameasuring cup 14; (VI) preparing the tape which includes: (a) taking thetape 26 out of the container 40; (b) measuring the tape 26 using theruler 42; (c) tearing the tape 26 into two strips approximately fourinches long for each drain; and (d) attaching a small corner of eachpiece of tape 26 to the edge of the counter, table or other surface; and(VII) labeling each drain using the numbered drain labels 30 whichincludes: (a) peeling the labels 30 off the backing starting with theDrain 1 label; and (b) wrapping one label around each tube near thebulb. It should be appreciated that this process can be skipped if thedrains are labeled.

Draining the Incision (Step II)

The second step of method of the present invention includes draining theincision as provided in FIGS. 3A and 3B or FIGS. 7A, 7B, 7C and 7D.Draining the incision includes: (I) unpinning or removing Drain 1 fromthe belt bag 28; (II) putting on a pair of gloves 12; (III) holding thebulb firmly and pointing the stopper over the measuring cup 14; (IV)opening the stopper and squeezing all of the contents of the bulb intothe measuring cup 14; (V) pinching the top of the tube at the exit sitewhile holding it so that is does not pull loose or out; (VI) pinchingthe tube while sliding downward, squeezing and pouring the last bit offluid from the bulb into the measuring cup 14; (VII) wiping the bulb'sstopper and insertion hole with a gauze pad 16; (VII) discarding thegauze pad 16 in the waste bag 20; (IX) folding the bulb in half to forceout all the air; (X) placing the bulb(s) and tubing inside the beltbags(s) 28 using one belt bag 28 for two bulbs; (XI) reading the levelof drainage on the measuring cup 14; (XII) recording the drainageincluding: (a) writing the amount on the drainage record card 34 (seeFIG. 6); and (b) labeling the card “Drain 1”; (XIII) disposing of thedrainage, preferably in the toilet; (XIV) placing the used measuring cup14 in the waste bag 20; (XV) repeating the above process for eachadditional drain, while keeping the gloves 12 on until the last bulb hasbeen emptied and drainage recorded; and (XVI) disposing of the glovesincluding (a) taking off the gloves 12; and (b) placing the gloves inthe waste bag 20.

Removing the Old Dressing (Step III)

The third step of the method of the present invention includes removingthe old dressing as illustrated in FIGS. 3A and 3B and FIGS. 7A, 7B, 7Cand 7D. Removing the old dressing includes: (I) washing which includes(a) using the antibacterial soap 24; (b) drying using the clean towel;(II) rubbing an adhesive remover pad 18 on the edges of the tape 26 andskin around the tube assisting in removal of the tape 26 (i.e., makeremoving the tape less painful); (III) removing the old gauze pad 16 andtape 26 by pulling the tape toward the exit site when the tape 26 isloosened; (IV) disposing of the tape 26 and old gauze pad 16, preferablyin the waste bag 20; and (V) repeating the process for each exit site.If the patient is allowed to shower, this third step further includes:(VI) showering while wearing the belt bag(s) 28 in the shower, whichincludes: (a) letting the water run over the incision(s); (b) gentlywashing around the incision; (b) drying using only the clean, freshtowel while patting, not rubbing, the incision area(s); (c) putting onas many dry belt bags 28 as needed; (d) moving the bulbs to the drybag(s) 28; and (e) hanging the wet belt bag(s) 28 to dry.

Replacing the Dressing (Step IV)

The fourth step of method of the present invention includes replacingthe dressing as illustrated in FIGS. 3A and 3B and FIGS. 7A, 7B, 7C and7D. Replacing the dressing includes (I) protecting the uncoveredincision from catching or snagging, which includes: (a) tearing off apiece of Micropore™ Tape 26 from the roll; and (b) placing it over theincision(s); (II) taking a slit gauze pad with foam support bar 32 outof the box 40; (III) positioning the drain tube, which includes: (a)placing the pad 32 under the drain tube so that the tube sits in theslit; and (b) resting the drain tube on the foam bar for support; (IV)taping the slot gauze pad with foam support bar 32 in place, whichincludes: (a) using the tape 26 prepared previously (see Step I above)to tape along one edge of the pad 32; and (b) placing another piece oftape 26 on the other side of the pad; (V) repeating this process foreach of the drains; and (VI) twisting the tie around the waste bag 20and throwing it away.

Yet another embodiment of the present invention includes teaching orinstructing the patient or user in the use of the system 10. The systemincludes a copy of the set of extremely detailed and specificstep-by-step instructions 44 or 44A, as illustrated in FIGS. 4 and FIGS.8A and 8B and discussed previously, for a medical care professional orclinician. The medical care professional uses the copy of theinstructions to document the instructions provided to the patient oruser, familiarizing the patient or user with the method and system 10.The instructions enables the medical care professional to ensure thatthe training is complete, providing a plurality of places 45 a, 45 b, 45c, 45 d, 45 e, 45 f, 45 g, and 45 h for the patient or user to indicatethey have received and understand the instructions. These instructions44 or 44A are maintained by the clinician or medical provider as part ofthe clinical record, where they may by used for accreditation and/orlegal purposes.

It will be appreciated that the system 10 may contain sufficientapparatus for one or more dressing changes, for example, apparatus for1, 5, 10, 15, 20, 25, 30, 40 or 50 dressing changes. Further, it shouldbe appreciated that refills for system 10 may be provided. For example,additional gauze pads 16 or tape 26 may be provided as required by theuser. The antibacterial soap 24 may be in liquid or bar form. The tapeis preferably a roll of Micropore™ tape 26. The measuring cups 14 arepreferably calibrated. The step-by-step instructions 38 or 38A and 44 or44A, the contents map 36, the numbered drain labels 30 and the drainagerecord cards 34 may be written in any language, including English,Spanish, French, etc.

The present invention further contemplates a method for instructing oreducating users in post-surgery drain site care in accordance with thestep-by-step instructions provided in the patient discharge system ofthe present invention. More specifically, the system includes self-caredocumentation 38, 38A, 44 and 44A. An instructor such as a doctor,nurse, clinician, other medical professional or any individual trainedto educate users in caring for a post-surgery drain site uses thestep-by-step instructions to instruct the user to care for thepost-surgery drain site, preferably using the system of the presentinvention. The instructor takes the user through the method of thepresent invention and may even demonstrate specific procedures usingspecific items of the system of the present invention. It should also beappreciated that the system, including the step-by-step instructions ofthe present invention could be employed by the patient forself-education.

Federal, state and local regulatory agencies require full documentationof training provided by the medical care professional. The medical careprofessional uses the documentation described above to document theinstructions provided to the patient or user, familiarizing the patientor user with the method and system of the present invention. The copy ofthe instructions enable the medical care professional to ensure that thetraining is complete, providing acknowledgment sections 44A through 44Hfor the patient or user to indicate (i.e., initial or signed) that theyhave received and understand the instructions. This documentation ismaintained by the clinician or medical provider as part of the clinicalrecord, were they may be used for accreditation and/or legal purposes.

While the invention has been described in connection with what ispresently considered to be the most practical and preferred embodiments,it is to be understood that the invention is not limited to thedisclosed embodiments, but on the contrary is intended to cover variousmodifications and equivalent arrangements included within the spirit andscope of the appended claims. Thus, it is to be understood thatvariations in the present invention can be made without departing fromthe novel aspects of this invention as defined in the claims.

The invention is hereby claimed as follows:
 1. A system for care of apost-surgical drain site by a patient, said system comprising: (a) atleast one pair of gloves; (b) at least one measuring cup; (c) at leastone gauze pad; (d) at least one tape remover; (e) antibacterial soap;(f) at least one securing device; (g) at least one belt bag; (h) atleast one drain label; (i) at least one split gauze pad with foamsupport bar; (j) at least one drainage record card; (k) at least one setof step-by-step instructions; and (l) at least one container for holdingapparatus (a) to (k).
 2. The system of claim 1, wherein the container isa box and wherein items (a) through (k) are positioned inside the boxaccording to a contents map.
 3. The system of claim 2, wherein saidsystem contains apparatus for a plurality of self-care procedures. 4.The system of claim 3, wherein the antibacterial soap is in liquid form.5. The system of claim 3, which includes at least one waste bag.
 6. Thesystem of claim 3, further including a tape within a roll.
 7. The systemof claim 3, wherein the measuring cup is calibrated.
 8. The system ofclaim 3, which includes at least one set of clinician step-by-stepinstructions for documenting instructions provided to the patient in theuse of the system.
 9. A method for self-care of a post-surgical drainsite by a patient comprising caring for a post-surgical drain site withthe system of claim
 1. 10. The method of claim 9, which includes caringfor the post-surgical drain site by following said step-by-stepinstructions.
 11. The method of claim 9, which includes preparing forself-care of a post-surgical drain.
 12. The method of claim 9, whichincludes draining the post-surgical drain site.
 13. A system for atleast 30 self-care procedures for a post-surgical drain site by apatient, said system comprising: (a) 20 pairs of gloves; (b) 30calibrated measuring cups; (c) 30 gauze pads; (d) 30 adhesive taperemover pads; (e) a writing instrument; (f) antibacterial liquid soap;(g) a roll of tape; (h) 4 belt bags; (i) 4 numbered drain labels; (j) 30split gauze pads with foam support bars; (k) 4 drainage record cards;(l) a set of step-by-step instructions; and (m) a box adapted to holdapparatus (a) through (l).
 14. The system of claim 13, which includes atleast one set of clinician step-by-step instructions for documentinginstructions provided to the patient in the use of the system.